摘要
目的探讨高压氧对深Ⅱ度复合性烧伤创面的影响及其可能机制。方法50只Wistar大鼠为实验动物,建立深Ⅱ度复合性烧伤模型后,随机分为3组,单纯植皮组(实验组)、植皮配合高压氧治疗组(治疗组)及对照组,分别于伤后第3天行切痂自体皮片移植术,术后加压包扎固定。治疗组治疗给氧压为0.1MPa,一级导管给氧,升压18min,给压60min,减压18min,每日1次,共治疗7次。于伤后10、14、18、24、31天时相点对创面组织形态改变、微血管密度及成纤维细胞超微结构变化、表皮细胞增殖情况进行检测。结果高压氧治疗可使创面愈合时间缩短3～5天,促进肉芽组织的形成(P<0.05),加速成纤维细胞的生长,加速上皮细胞的DNA复制,瘢痕质地软而光滑。结论复合性烧伤后在单纯植皮基础上辅助高压氧治疗,皮片生长及成活情况良好,创面愈合时间快,感染率明显降低,治疗组的修复早于实验组和对照组,瘢痕形成减少,提示该治疗方法在西部高海拔地区临床外科中的推广应用,能缩短患者住院时间,愈后并发症轻,且方法简便易行,治疗效果满意。
Purpose To explore the effect and possible mechanism of hyperbaric oxygen （HBO） on burn wound healing of the rats. Methods A total of 50 Wistar rats with both sexes were used to establish a chemical burning model. Rats were randomly divided into 3 groups ： graft, graft in combination with HBO, and a control group. The graft was applied to burn wound on day 3 after burning. The grafted tissue was fixed using pressure wrapping. The treatment group received a HBO with 0. 1 Mpa. Oxygen was provided through type 1 tubes. Pressure was gradually elevated to 0. 1 Mpa within 18 min, and maintained at this level for 60 min. Then the oxygen pressure was gradually reduced within 18 rain. Treatment were performed once a day for 7 days. The histological and morphological changes at the end of treatment, the structure of the graft and the growth of fibroblasts and epidermal cells were observed. The number of capillary vessels, the degree of inflammation as well as changes of collagen fibers were detected after application of HBO. Burn wound healing time and granulation tissues were observed on the 10, 14, 18, 24, and 31 days after burning. Results Burn wound healing time was shorted 3 - 5 days, growth of granulation tissue was promoted after HBO treatment （ P 〈 0. 05 ）. Fibroblastic growth and cellular DNA replication were accelerated（P 〈 0.05 ） ; Newly formed collagen fibers appeared earlier, and the scar was soft and smooth. Conclusions The combination of skin grafting and HBO is effective in the treatment of chemical burns. Graft growth and survival are much improved in graft/HBO group. Shorter wound healing time, lower infection rate, and less scar formation are also observed in this group. Graft/HBO treatment possibly requires less time in hospital but still can achieve satisfactory results. The procedure is easy to perform. Based on these findings, graft/HBO treatment is worthy of clinical trial in the west high-altitude region.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2009年第2期187-191,共5页
Chinese Journal of Clinical and Experimental Pathology
